If a member has avalid reason for agrievance and theyare upset but thecall ends before youfile the grievance,what do you do?What systemdo you useto check if aprocedure iscovered?If a Covid test wasdenied coverageby insurancecompany, what isthe first thing youcheck in HRP?What systemdo youcheck to seethe status ofan appeal?If a member callsin upset and youdo not know if youshould file agrievance, whatKA should youlook up and read?If its a SilentEnrollment periodand there is noenrollment window inBSwift, what do youdo to enroll memberinto their desiredplan? (non-Fed)If a member hasquestions aboutreimbursements,what should weoffer themember?What happens ifyou cant find theplan sponsor inthe list oftoolkits? (andNOT ORS)Before youagree to accepta transferredcall, what doyou do first?If a Traditional(Commercial)Fed/Postalmember calls in toopt-out ofSilverscripts, whodo you transfer to?What is theOneKit codefor a memberreimbursementform?What is thetimely filingperiod for agrievance?If an expeditedappeal is changedto a standardappeal by Aetna,what does themember have aright to do?🍎If a provider isleaving thenetwork, whatform should weoffer themember?What s theTAT for aclaimdecision tobe made?Why does USSteel have thenew TraditionalChoice MNplan as anoption?How do yousend amember acopy of theirEOB?What is thedifference betweena routinemammogram anda diagnosticmammogram?What 2systems do youuse to check anapprox. cost ofa procedure?When does theTraditionalChoice MNplan SilentEnrollmentend?What is "Step1" in theenrollmentprocess withFed/Postalmembers?If a member asksabout reimbursementfor eyewear orhearing aids, whatshould we check firstbefore sending out aform?If a member with aW-Id calls in aboutclaims or benefitsand you're notTrad Trained, whatdo you do?If someone otherthan the memberis calling in, whatshould we offer toassist with futurecalls?If a member has avalid reason for agrievance and theyare upset but thecall ends before youfile the grievance,what do you do?What systemdo you useto check if aprocedure iscovered?If a Covid test wasdenied coverageby insurancecompany, what isthe first thing youcheck in HRP?What systemdo youcheck to seethe status ofan appeal?If a member callsin upset and youdo not know if youshould file agrievance, whatKA should youlook up and read?If its a SilentEnrollment periodand there is noenrollment window inBSwift, what do youdo to enroll memberinto their desiredplan? (non-Fed)If a member hasquestions aboutreimbursements,what should weoffer themember?What happens ifyou cant find theplan sponsor inthe list oftoolkits? (andNOT ORS)Before youagree to accepta transferredcall, what doyou do first?If a Traditional(Commercial)Fed/Postalmember calls in toopt-out ofSilverscripts, whodo you transfer to?What is theOneKit codefor a memberreimbursementform?What is thetimely filingperiod for agrievance?If an expeditedappeal is changedto a standardappeal by Aetna,what does themember have aright to do?🍎If a provider isleaving thenetwork, whatform should weoffer themember?What s theTAT for aclaimdecision tobe made?Why does USSteel have thenew TraditionalChoice MNplan as anoption?How do yousend amember acopy of theirEOB?What is thedifference betweena routinemammogram anda diagnosticmammogram?What 2systems do youuse to check anapprox. cost ofa procedure?When does theTraditionalChoice MNplan SilentEnrollmentend?What is "Step1" in theenrollmentprocess withFed/Postalmembers?If a member asksabout reimbursementfor eyewear orhearing aids, whatshould we check firstbefore sending out aform?If a member with aW-Id calls in aboutclaims or benefitsand you're notTrad Trained, whatdo you do?If someone otherthan the memberis calling in, whatshould we offer toassist with futurecalls?

Random BSwift Knowledge - Call List

(Print) Use this randomly generated list as your call list when playing the game. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


1
A A
2
O O
3
T T
4
A A
5
E E
6
T T
7
A A
8
O O
9
T T
10
N N
11
O O
12
E E
13
N N
14
A A
15
O O
16
N N
17
N N
18
O O
19
A A
20
E E
21
E E
22
T T
23
E E
24
N N
  1. A-If a member has a valid reason for a grievance and they are upset but the call ends before you file the grievance, what do you do?
    A-
  2. O- What system do you use to check if a procedure is covered?
    O-
  3. T-If a Covid test was denied coverage by insurance company, what is the first thing you check in HRP?
    T-
  4. A-What system do you check to see the status of an appeal?
    A-
  5. E-If a member calls in upset and you do not know if you should file a grievance, what KA should you look up and read?
    E-
  6. T-If its a Silent Enrollment period and there is no enrollment window in BSwift, what do you do to enroll member into their desired plan? (non-Fed)
    T-
  7. A-If a member has questions about reimbursements, what should we offer the member?
    A-
  8. O-What happens if you cant find the plan sponsor in the list of toolkits? (and NOT ORS)
    O-
  9. T-Before you agree to accept a transferred call, what do you do first?
    T-
  10. N-If a Traditional (Commercial) Fed/Postal member calls in to opt-out of Silverscripts, who do you transfer to?
    N-
  11. O-What is the OneKit code for a member reimbursement form?
    O-
  12. E-What is the timely filing period for a grievance?
    E-
  13. N-If an expedited appeal is changed to a standard appeal by Aetna, what does the member have a right to do?
    N-
  14. A-If a provider is leaving the network, what form should we offer the member?
    A-🍎
  15. O-What s the TAT for a claim decision to be made?
    O-
  16. N-Why does US Steel have the new Traditional Choice MN plan as an option?
    N-
  17. N-How do you send a member a copy of their EOB?
    N-
  18. O-What is the difference between a routine mammogram and a diagnostic mammogram?
    O-
  19. A-What 2 systems do you use to check an approx. cost of a procedure?
    A-
  20. E-When does the Traditional Choice MN plan Silent Enrollment end?
    E-
  21. E-What is "Step 1" in the enrollment process with Fed/Postal members?
    E-
  22. T-If a member asks about reimbursement for eyewear or hearing aids, what should we check first before sending out a form?
    T-
  23. E-If a member with a W-Id calls in about claims or benefits and you're not Trad Trained, what do you do?
    E-
  24. N-If someone other than the member is calling in, what should we offer to assist with future calls?
    N-